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Why COVID-19 is killing U.S. diabetes patients at alarming rates

By Chad Terhune, Deborah J. Nelson and Robin Respaut

(Reuters) – Devon Brumfield could hear her father gasping for breath on the phone.

Darrell Cager Sr., 64, had diabetes. So his youngest daughter urged him to seek care. The next day, he collapsed and died in his New Orleans home.

The daughter soon learned the cause: acute respiratory distress from COVID-19. His death certificate noted diabetes as an underlying condition. Brumfield, who lives in Texas and also has type 2 diabetes, is “terrified” she could be next.

“I’m thinking, Lord, this could happen to me,” she said of her father’s death in late March.

She has good reason to fear. As U.S. outbreaks surge, a new government study shows that nearly 40% of people who have died with COVID-19 had diabetes.

Among deaths of those under 65, half had the chronic condition. The U.S. Centers for Disease Control and Prevention analyzed more than 10,000 deaths in 15 states and New York City from February to May.

Jonathan Wortham, a CDC epidemiologist who led the study, called the findings “extremely striking,” with serious implications for those with diabetes and their loved ones.

A separate Reuters survey of states found a similarly high rate of diabetes among people dying from COVID-19 in 12 states and the District of Columbia.

Ten states, including California, Arizona and Michigan, said they weren’t yet reporting diabetes and other underlying conditions, and the rest did not respond – rendering an incomplete picture for policymakers and clinicians struggling to protect those most at-risk.

America’s mortality rates from diabetes have been climbing since 2009 and exceed most other industrialized nations. Blacks and Latinos suffer from diabetes at higher rates than whites and have disproportionately suffered from COVID-19.

“Diabetes was already a slow-moving pandemic. Now COVID-19 has crashed through like a fast-moving wave,” said Elbert Huang, a professor of medicine and director of the University of Chicago’s Center for Chronic Disease Research and Policy.

Keeping diabetes under control – among the best defenses against COVID-19 – has become difficult as the pandemic disrupts medical care, exercise and healthy eating routines.

The high price of insulin has also forced some people to keep working – risking virus exposure – to afford the essential medicine. And as the country grapples with an economic crisis, millions of Americans have lost their jobs and their employer-sponsored health insurance.

Much of this could have been anticipated and addressed with a more comprehensive, national response, said A. Enrique Caballero, a Harvard Medical School endocrinologist and diabetes researcher.

Top health officials should have done more to emphasize the threat to people with diabetes and assuage their fears of hospital visits, he said, while also focusing more on helping patients manage their condition at home.

Policymakers had ample warning that COVID-19 posed a high risk for diabetes patients. In 2003, during the coronavirus outbreak known as SARS, or Severe Acute Respiratory Syndrome, more than 20% of people who died had diabetes.

In 2009, during the H1N1 flu pandemic, patients with diabetes faced triple the risk of hospitalization.

Most recently in 2012, when the coronavirus Middle East Respiratory Syndrome, or MERS, emerged, one study found 60% of patients who entered intensive care or died had diabetes.

The COVID-19 pandemic, however, has unearthed previously unknown complications because it has lasted longer and infected many more people than earlier coronavirus epidemics, said Charles S. Dela Cruz, a Yale University physician-scientist and Director of the Center of Pulmonary Infection Research and Treatment.

Doctors warn that the coronavirus pandemic may indirectly lead to a spike in diabetes-related complications – more emergency-room visits, amputations, vision loss, kidney disease and dialysis.

“My fear is we will see a tsunami of problems once this is over,” said Andrew Boulton, president of the International Diabetes Federation and a medical professor at the University of Manchester in England.

‘ONE BIG PUZZLE’

Researchers have scrambled for months to unravel the connections between diabetes and the coronavirus, uncovering an array of vulnerabilities.

The virus targets the heart, lung and kidneys, organs already weakened in many diabetes patients. COVID-19 also kills more people who are elderly, obese or have high blood pressure, many of whom also have diabetes, studies show.

On the microscopic level, high glucose and lipid counts in diabetes patients can trigger a “cytokine storm,” when the immune system overreacts, attacking the body. Damaged endothelial cells, which provide a protective lining in blood vessels, can lead to inflammation as white blood cells rush to attack the virus and may cause lethal clots to form, emerging research suggests.

“It’s all one big puzzle,” said Yale’s Dela Cruz. “It’s all interrelated.”

Many of their vulnerabilities can be traced to high blood sugar, which can weaken the immune system or damage vital organs. COVID-19 appears not only to thrive in a high-sugar environment but to exacerbate it. Recent evidence suggests the virus may trigger new cases of diabetes.

David Thrasher, a pulmonologist in Montgomery, Alabama, said up to half of COVID-19 patients in his local hospital ICU have diabetes. “They are often my most challenging patients,” he said, and the immune system response may be a big reason why.

‘DIABETES BELT’

The pandemic has ripped through several southern states with some of the nation’s highest diabetes rates. A Reuters examination of state data found that nearly 40% of COVID-19 deaths were people with diabetes in Alabama, Louisiana, Mississippi, North Carolina, South Carolina and West Virginia. Much of this area lies within what the CDC calls the “diabetes belt.”

Alabama has the highest percentage of adults with diabetes at 13.2%, or more than 550,000 people, CDC data show. Diabetes patients accounted for 38% of the state’s COVID-related deaths through June, officials said. Karen Landers, Alabama’s assistant state health officer, said she is particularly heartbroken at the deaths of diabetes patients in their 30s and 40s.

Medical professionals in these states say they struggle to keep patients’ diabetes under control when regular in-person appointments are canceled or limited because of the pandemic.

Sarah Hunter Frazer, a nurse practitioner at the Medical Outreach Ministries clinic for low-income residents in Montgomery, Alabama, said diabetes is common among her COVID-19 patients. With clinic visits on hold, she stays in touch by phone or video chat. If a problem persists, she insists on an outdoors, face-to-face meeting. “We meet them under a shade tree behind the clinic,” Frazer said.

In similar fashion, doctors at the University of North Carolina stepped up their use of telemedicine to reach at-risk rural patients. Despite those efforts, John Buse, a physician and director of the university’s diabetes center, said he’s certain some foot ulcers and dangerously high blood sugars are being missed because people avoid health facilities for fear of the virus.

‘UNDER CONTROL’

Many diabetes patients with severe or deadly cases of COVID-19 were in good health before contracting the virus.

Clark Osojnicki, 56, of Stillwater, Minnesota, had heard early warnings about the risks of the coronavirus for people with diabetes, said his wife, Kris Osojnicki. But the couple didn’t think the admonitions applied to him because his glucose levels were in a healthy range.

“He was incredibly active,” she said.

On a Sunday in mid-March, Osojnicki jogged alongside his border collie, Sonic, on an agility course for dogs inside a suburban Minneapolis gym. Three days later, Osojnicki developed a fever, then body aches, a cough and shortness of breath. He was soon in the hospital, on a ventilator. Clark, a financial systems analyst, died April 6 from a blood clot in the lungs.

Osojnicki is among 255 recorded deaths in Minnesota of people with COVID-19 and diabetes mentioned on their death certificate as of mid-July, according to state data. The records describe people who died as young as 34.

WORKING FOR INSULIN

For years, the skyrocketing cost of insulin has fueled much of the national outrage over drug prices. Early in the pandemic, the American Diabetes Association asked states to eliminate out-of-pocket costs for insulin and other glucose-lowering medications through state-regulated insurance plans.

But no state has fully followed that advice, the ADA said. Vermont suspended deductibles for preventive medications, like insulin, starting in July. Other states ordered insurers to make prescription refills more available but didn’t address cost.

Robert Washington, 68, knew his diabetes put him at risk from COVID-19. When his employer, Gila River’s Lone Butte Casino in Chandler, Arizona, reopened in May, he decided to keep working as a security guard so he could afford insulin.

Washington’s supervisors had assured him he could patrol alone in a golf cart, said his daughter, Lina. But once back at work, he was stationed at the entrance, where long lines of gamblers waited, most without masks, Robert told his daughter.

“He was terrified at what he saw,” Lina said.

He tested positive for the virus in late May and was admitted to the hospital days later. He died from complications of COVID-19 on June 11, his daughter said.

A week after Washington’s death, the casino again closed as COVID-19 cases exploded in the state. The casino did not respond to a request for comment.

“It’s hard to accept he is gone. I have to stop myself from wanting to call him,” said Lina, a sports anchor and reporter at a Sacramento, California, TV station. “A lot of these deaths were in some way preventable.”

(Reporting by Chad Terhune, Deborah J. Nelson and Robin Respaut; Editing by Brian Thevenot)

Good vibrations? COVID quiet time soothes Earth’s seismic shakes

By Kate Kelland

LONDON (Reuters) – COVID-19 lockdowns worldwide led to the longest and most pronounced reduction in human-linked seismic vibrations ever recorded, sharpening scientists’ ability to hear earth’s natural signals and detect earthquakes, a study found on Thursday.

Vibrations travel through the earth like waves, creating seismic noise from earthquakes, volcanoes, wind and rivers as well as human actions such as travel and industry.

In the study, published in the journal Science and conducted using international seismometer networks, scientists found that human-linked earth vibrations dropped by an average of 50% between March and May this year.

“The 2020 seismic noise quiet period is the longest and most prominent global anthropogenic seismic noise reduction on record,” they wrote. The work was co-led by the Royal Observatory of Belgium and five other institutions using data from 268 monitoring stations in 117 countries.

Beginning in China in late January, and followed by Europe and the rest of the world in March to April, researchers saw “a wave of quietening” as worldwide lockdown measures to slow the coronavirus pandemic took hold.

Travel and tourism were all but halted, millions of schools and industries closed, and many people were confined to their homes.

The relative quiet allowed scientists to “listen in” in more detail on the earth’s natural vibrations, said Stephen Hicks, a seismologist at Imperial College London who co-led the work.

“It has yielded a new window on the natural seismic signals, and could let us see more clearly than ever what differentiates human and natural noise,” he said.

The study said its findings also showed that seismologists can help establish how long people take to react to the imposition and lifting of lockdown measures.

The largest drops in human-induced vibrations were seen in densely populated areas like Singapore and New York City, but drops were also seen in remote areas like Germany’s Black Forest and Rundu in Namibia. Barbados, where lockdown coincided with the tourist season, saw a 50% drop in seismic noise.

(Reporting by Kate Kelland, editing by Philippa Fletcher)

New York’s Cuomo announces new restrictions on bars and restaurants after compliance issues

(Reuters) – Bars and restaurants in New York City that receive three “strikes” for failing to enforce social distancing will be forced to close, Governor Andrew Cuomo said on Thursday.

In addition, bars and restaurants across the state will be allowed to serve alcohol only to patrons also ordering food, and walk-up bar service will not be allowed.

The governor announced the restrictions after numerous reports of compliance issues.

“There is significant evidence of failure to comply,” Cuomo said during a conference call with reporters. “It’s wrong, it’s dangerous, it’s selfish, it’s unacceptable. It’s also illegal.” Separately, an announcement on whether New York City would enter Phase 4 of reopening will be made at 4 p.m. EST on Friday, Cuomo said.

(Reporting by Maria Caspani, Editing by Chizu Nomiyama)

After 100 days, New Yorkers can get haircuts, dine outdoors while virus cases soar in 12 other states

By Maria Caspani

NEW YORK (Reuters) – After more than 100 days of lockdown, New York City residents on Monday celebrated their progress in curbing the coronavirus pandemic by getting their first haircuts in months, shopping at long-closed stores, and dining at outdoor cafes.

Once the epicenter of the global outbreak, New York City was the last region in the state to move into Phase 2 of reopening with restaurants and bars offering outdoor service and many shops reopening. Barber shops and hair salons welcomed customers for the first time since mid-March.

Playgrounds were also due to reopen on Monday in the most populous U.S. city. The pandemic has killed nearly 120,000 Americans.

At the same time, a dozen states in the South and Southwest reported record increases in new coronavirus cases – and often record increases in hospitalizations as well, a metric not affected by more testing.

The number of new cases rose by a record last week in Arizona, California, Florida and Texas, together home to about a third of the U.S. population. Alabama, Georgia, Nevada, Oklahoma, Oregon, South Carolina, Utah and Wyoming also experienced record spikes in cases.

On Saturday more than 6,000 people, mostly without masks, crowded together inside a Tulsa, Oklahoma, arena for a campaign rally by President Donald Trump.

Trump defended his response to COVID-19, saying more testing had led to identifying more cases, seemingly to his chagrin.

“When you do testing to that extent, you’re going to … find more cases,” he said. “So, I said to my people, ‘Slow the testing down, please.'” A White House official said he was “obviously kidding” with that remark.

(Reporting by Maria Caspani in New York; Additional reporting by Peter Szekely in New York; Writing by Lisa Shumaker; Editing by Howard Goller)

Trump opposed to removing Theodore Roosevelt’s statue from outside Museum of Natural History

By Kanishka Singh

(Reuters) – U.S. President Donald Trump said on Monday he opposed removing the towering statue of Theodore Roosevelt from outside New York City’s American Museum of Natural History.

The move was announced by the museum on Sunday and comes amid anti-racism protests across the United States and the world after the death of an unarmed black man, George Floyd, in police custody on May 25 in the United States.

The statue shows Roosevelt on a horse, with a Native American man and an African man by his side. It stands prominently on a plinth outside the museum’s main entrance, overlooking Central Park.

Roosevelt, a Republican like Trump, was U.S. president from 1901-1909. Known for his exuberant and daring manner, he carried out antitrust, conservationist and “Square Deal” reforms, and, critics said, took an interventionist approach to foreign policy, including projecting U.S. naval power around the world.

Many critics have said the Roosevelt statue symbolizes racial discrimination and colonial expansion.

New York City Mayor Bill de Blasio said on Sunday that the city was in favor of the request from the museum to remove the statue because it “depicts black and indigenous people as subjugated and racially inferior.”

“Ridiculous, don’t do it,” Trump said in a tweet on Monday.

In the ongoing ant-racism demonstrations, protesters across the United States and around the world have demanded that authorities take down monuments honoring pro-slavery Confederate figures and the architects of Europe’s colonies.

“Simply put, the time has come to move it,” the museum’s president, Ellen Futter, told the New York Times.

She said the museum’s decision was based on the statue itself, along with its “hierarchical composition”, and not on Roosevelt. Futter said the museum continues to honor Roosevelt as “a pioneering conservationist”.

Roosevelt’s face is also one of the four presidents – along with George Washington, Thomas Jefferson and Abraham Lincoln – whose faces are cast in 60-foot-high granite sculptures at the Mount Rushmore National Memorial in South Dakota.

Trump has blasted the anti-racism protests, saying demonstrators have behaved badly.

“The unhinged left-wing mob is trying to vandalize our history, desecrate our monuments – our beautiful monuments – tear down our statues and punish, cancel and persecute anyone who does not conform to their demands for absolute and total control. We’re not conforming”, the U.S. president told supporters at a rally last week.

(Reporting by Kanishka Singh in Bengaluru Editing by Gerry Doyle, Toby Chopra and Mark Heinrich)

Constant fireworks frazzle nerves in U.S. city that never sleeps

By Barbara Goldberg

NEW YORK (Reuters) – Complaints are skyrocketing about thundering fireworks exploding over otherwise quiet U.S. neighborhoods, fraying nerves already frazzled by COVID-19 lockdown restrictions.

Even in the city that never sleeps, weary New Yorkers in the first half of June lodged a one-hundredfold increase in complaints compared to the year-ago period, of explosions that begin before sundown and rattle windows into the morning. The city’s 311 hotline received 2,492 fireworks complaints from June 1-16, up from just 25 in the same period in 2019.

The pyrotechnics occur almost nightly across the five boroughs of New York, once the U.S. epicenter of coronavirus infections, which recently achieved the nation’s lowest rate of virus spread.

“We have been terrorized by the fireworks for weeks now,” said Tanya Bonner, a government policy consultant in her 40s who lives in upper Manhattan, where Columbia University’s athletics complex had been converted into a COVID-19 field hospital.

“It is very bad up here. This area also has many essential workers – and they need rest.”

Bonner, who suffers from diabetes, high blood pressure and asthma and must leave her apartment windows open, said she can sleep only by turning her television volume “way up” even though “the fireworks happen so close to my window that it is impossible to drown it out.”

To get some shuteye, another upper Manhattan resident said she closes all windows and muffles the blasts by turning on a noisy air conditioner, a fan, a white noise machine and screwing in some tight-fitting earplugs.

“Fireworks are illegal in New York City,” New York Police Detective Sophia Mason responded in an email. But neighboring New Jersey legalized some fireworks in 2017.

From Jan. 1 through June 14, the New York Police Department has seized fireworks on 26 occasions, made eight arrests, issued 22 criminal court summonses, and responded to 2 fireworks-related injuries, Mason said.

In Massachusetts, which has the country’s strictest prohibitions against fireworks, police blamed a spike in complaints in Boston and other municipalities on a stretch of warmer weather after months of stay-at-home orders.

“It’s just been months now of young people being inside, being bored,” said Lieutenant Sean Murtha of the Worcester Police Department, roughly 47 miles (76 km) west of Boston.

“It’s been a stressful time for everybody, an oppressive time,” said Murtha, who noted recent reports of gunshots that turned out to be fireworks were double the five-year average, totaling 27 in May, the most recent data available.

In upstate New York, Syracuse residents said they were being pushed to the brink by the pyrotechnics and more than 530 have signed a petition demanding Mayor Ben Walsh “crack down on constant fireworks” that have been booming since May.

“These are not merely a nuisance, but extremely traumatic for service members with PTSD,” Scott Upham Jr., a Syracuse resident who started the petition, said on Change.org.

Others said the noise was particularly bothersome for people with autism and family pets and worried that the fireworks create a fire hazard.

Mayor Walsh did not immediately respond to a request for comment.

(Additional reporting by Aleksandra Michalska; Editing by Richard Chang)

Trump pushes military response as U.S. girds for more protests

By Nathan Layne and Brendan O’Brien

NEW YORK/MINNEAPOLIS (Reuters) – President Donald Trump on Tuesday said U.S. troops should take to the streets of New York City to quell unrest, as authorities across the country prepared for another night of protests over the death of an unarmed black man in police custody.

Dozens of cities are under curfews. The head of the U.S. National Guard said on Tuesday that 18,000 Guard members were assisting local law enforcement in 29 states.

Lawmakers and law enforcement officials seemed taken aback by the extent of mayhem overnight in some major U.S. cities where police were shot at and pelted with rocks and projectiles as they faced hostile crowds.

Demonstrators smashed windows and looted stores in New York, including luxury retailers on Fifth Avenue, and set fire to a Los Angeles strip mall. Four officers were shot in St. Louis and one in Las Vegas who was critically wounded, authorities said.

Trump has threatened to use the military to battle violence that has erupted nightly, often after a day of peaceful protests. He has derided local authorities, including state governors, for their response to the disturbances.

“NYC, CALL UP THE NATIONAL GUARD. The lowlifes and losers are ripping you apart. Act fast!” Trump tweeted on Tuesday. He deploying thousands of armed soldiers and law enforcement in the U.S. capital and vowed to do the same wherever authorities fail to regain control.

New York Governor Andrew Cuomo voiced outrage at the chaos in America’s largest city, saying its mayor and police force “did not do their job last night.” He said he believed Mayor Bill de Blasio underestimated the scope of the problem.

The governor said he had offered the state’s mayors support from state police or 13,000 National Guard who are on standby and said that with a 38,000-strong police force, New York City should be able to address its unrest on its own.

He added that Trump sought to blur the line between protesters representing a cross-section of Americans with a legitimate cause and looters. Authorities blame the looting and vandalism on a relatively small number of people protesting against police brutality.

De Blasio poured cold water on the idea of deploying the National Guard in his city.

Demonstrators have taken to the streets over the death of George Floyd, a 46-year-old African American who died after a white policeman pinned his neck under a knee for nearly nine minutes in Minneapolis on May 25.

Derek Chauvin, the 44-year-old Minneapolis police officer who planted his knee on Floyd’s neck, has been charged with third-degree murder and second-degree manslaughter. Three other officers involved have not been charged.

MARTIN LUTHER KING REMEMBERED

Floyd’s death has reignited the explosive issue of police brutality against African Americans and led to a painful reexamination of race relations five months before a divided America votes in a presidential election.

Some of those who have gathered at the site of Floyd’s killing have invoked the non-violent message of the late U.S. civil rights leader Martin Luther King Jr., assassinated in 1968, as the only way forward.

“He would be truly appalled by the violence because he gave his life for this stuff,” said Al Clark, 62, a black man who drove to the Minneapolis memorial with one of King’s speeches blaring from his truck.

“But I can understand the frustration and anger.”

In Atlanta, six officers will face charges for an incident in which two college students were removed from their car and tased, Fulton County District Attorney Paul Howard told a briefing. Two of the six officers were terminated on Sunday.

A police officer in Sarasota, Florida, was placed on leave on Tuesday after video surfaced showing the officer kneeling on a man’s back and neck during an arrest in May.

Officers were injured in clashes elsewhere, including one who was in critical condition after being hit by a car in the Bronx, police said.

The protests have escalated racial tensions in a country hit hard by the coronavirus pandemic, with African Americans making up a disproportionately high number of cases and being hard hit by job losses from lockdowns to stop the spread of the virus.

Critics accuse Trump, who is seeking re-election in a Nov. 3 election, of further stoking conflict and racial tension rather than seeking to bring the country together and address the underlying issues.

“President Trump is right to be focused on law and order. He wasn’t hired to be the consoler-in-chief,” said Jason Miller, who advised the Republican Trump’s 2016 presidential campaign.

Democratic presidential candidate Joe Biden pledged in a speech on Tuesday to try to heal the racial divide in America and blasted Trump’s response to the protests.

(Reporting by Barbara Goldberg, Lisa Lambert, Maria Caspani, Peter Szekely, Zachary Fagenson, Brendan O’Brien, Nathan Layne, Susan Heavey and Brad Brooks; Writing by Paul Simao; Editing by Howard Goller)

NYC deaths from non-COVID causes rise over 5,000 above normal rate: CDC

Reuters) – The number of deaths in New York City from causes other than COVID-19 rose by more than 5,000 people above the seasonal norm during the first two months of the pandemic, the Centers for Disease Control and Prevention (CDC) said on Monday.

The deaths could be due to several factors, the CDC said, including delays in seeking or getting life-saving care for fear of exposure to the coronavirus.

Tracking excess mortality is vital in understanding the contribution to the death rate of both COVID-19 and poor availability of care for people with non-COVID conditions, noted researchers, who reported their findings in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

The CDC used data from the New York City Department of Health and Mental Hygiene, which has an electronic reporting system with a near complete count of all deaths in the city.

Between March 11 and May 2, 32,107 deaths were reported to the department. Of these, 24,172 were found to be in excess of the seasonal norm. This included 13,831 (57%) laboratory-confirmed COVID-19–associated deaths and 5,048 (21%) probable COVID-19–associated deaths.

That means 5,293, or 22% of the excess deaths, were not identified as being associated with COVID-19.

These deaths could be directly or indirectly attributed to the pandemic and counting only the confirmed or probable COVID-19–associated deaths likely underestimates deaths attributable to the pandemic, the researchers said.

(Reporting by Vishwadha Chander in Bengaluru; Editing by Arun Koyyur)

Why is New Orleans’ coronavirus death rate nearly three times New York’s? Obesity is a factor

By Brad Brooks

(Reuters) – The coronavirus has been a far deadlier threat in New Orleans than the rest of the United States, with a per-capita death rate almost three times that of New York City. Doctors, public health officials and available data say the Big Easy’s high levels of obesity and related ailments may be part of the problem.

“We’re just sicker,” said Rebekah Gee, who until January was the health secretary for Louisiana and now heads Louisiana State University’s healthcare services division. “We already had tremendous healthcare disparities before this pandemic – one can only imagine they are being amplified now.”

Along with New York and Seattle, New Orleans has emerged as one of the early U.S. hot spots for the coronavirus, making it a national test case for how to control and treat the disease it causes. Chief among the concerns raised by doctors working in the Louisiana city is the death rate, which is close to three times that of New York and over four times that of Seattle, based on publicly reported data.

New Orleans residents suffer from obesity, diabetes and hypertension at rates higher than the national average, conditions that doctors and public health officials say can make patients more vulnerable to COVID-19, the highly contagious respiratory disease caused by the coronavirus.

Some 97% of those killed by COVID-19 in Louisiana had a pre-existing condition, according to the state health department. Diabetes was seen in 40% of the deaths, obesity in 25%, chronic kidney disease in 23% and cardiac problems in 21%.

Orleans Parish, which encompasses the city, reported 115 deaths as of Wednesday, giving it 29.5 coronavirus deaths per 100,000 people. That rate for New York City was at 10.8 on Wednesday.

New Orleans could be a harbinger for the potential toll the pandemic could take in other parts of the South and Midwest that also have high rates of obesity, diabetes, and hypertension.

A host of other factors could contribute to New Orleans’ high death rate from COVID-19, ranging from access to healthcare and hospital quality, to the prevalence of other conditions, including lung disease, health officials say.

But they also note that it is clear that obesity-related conditions are playing a role in the deaths. That could be a warning sign for the United States at large, where chronic obesity is more common than in other developed countries, they said.

Hospitals are reporting cases across the generations -mothers and daughters, fathers and sons – being intubated and cared for in the same intensive care units, said Tracey Moffatt, the chief nursing officer at Ochsner Health, the largest healthcare provider in Louisiana. The prevalence of obesity, diabetes, hypertension and heart disease in New Orleans and Louisiana plays into that, she said.

Those family members often suffered from the same medical conditions before becoming sick, leaving them similarly vulnerable to the coronavirus despite their age gaps.

“We had a case where a mom was already in the ICU and the daughter, who was obese, came in,” she said. “The daughter asked staff to wheel her by her mom’s room so she could say goodbye before she herself was intubated. We knew the mother was going to pass away.”

Both patients suffered from obesity.

‘MORE VULNERABLE’

The Centers for Disease Control and Prevention this week released for the first time a report showing that 78% of COVID-19 patients in ICUs in the United States had an underlying health condition, including diabetes, cardiovascular disease and chronic lung disease.

The CDC report was based on a sample of under 6% of reported coronavirus infections, but doctors in Louisiana said it was consistent with what they are seeing, and it is in line with what other countries like Italy and China have faced.

Those percentages, said Dr. Joseph Kanter, an emergency department doctor and the top public health official in New Orleans, are likely similar in cities across the United States.

“What we worry about here is that we have more people in our communities with those conditions,” he said. “We’re more vulnerable than other communities, and the number of deaths we’ve seen illustrates that.”

The New Orleans metropolitan statistical area ranks among the worst in the United States for the percentage of residents with diabetes, high blood pressure and obesity, a Reuters analysis of CDC data shows. An estimated 39% have high blood pressure, 36% are obese and about 15% have diabetes.

Nationally, the median is 32% with high blood pressure, 31% obese and 11% with diabetes.

“The burden of disease in Louisiana and the Deep South is higher than in the rest of the country,” said Gee. “Invariably that means that the South is going to be hard hit by this.”

(This story corrects headline, paragraphs 1 and 3 to reflect actual death toll of Orleans Parish of 115 deaths; Inserts new paragraph 6 with breakdown of figures.)

(Reporting by Brad Brooks in Austin, Texas, additional reporting by Ryan McNeill in London; Editing by Scott Malone, Rosalba O’Brien and Dan Grebler)

How quarantine in my childhood home brought my family closer

By Nora Savosnick

OSLO, Norway (Reuters) – When President Trump announced the ban on travel from Europe last month, I was more than 3,000 miles away from my Norwegian childhood home, a 24-year-old photographer creating a life of my own in New York City.

I had to start thinking about whether I would risk my U.S. work visa – and my newfound freedom – to go home for nationalized health care and, most of all, to see my family. My mum recovered from cancer a few years ago: What if I couldn’t see her if she became sick again?

That evening I went on a first date to a trendy and still-crowded New York City restaurant. We said goodbye with a wave after applying hand sanitizer. As I eagerly awaited the after-text to see if he was into me, he sent me a message to go home to Norway while I still had the chance.

The next morning my parents called. “I want you to be here in case you should be sick,” said my mum, Chava Savosnick. “It’s kind of scary to have my daughter on the other side of the world in these times.”

In a panic, I bought a ticket back to Norway. I braced myself for a return to childhood, quarantined in my parents’ basement.

The basement looks the same as it did when I was 16, drinking my first few sips of hard cider with my friend Elena. The same books, the same movies, the same sofa bed. It felt comforting and a little claustrophobic at the same time.

So far, my mum hasn’t caught me drinking – or even snagging a scoop of forbidden ice cream. My childhood had very few sugary treats. As an adult rebelling against those childhood restrictions, I’d buy at least three Ben and Jerry’s pints a week.

Now, because I had to be in quarantine for two weeks after my arrival from America, my parents were in total control of my diet. I was rationed on the number of days I can fry my breakfast or have even a single egg. My mum is worried about my cholesterol and potential for high blood pressure.

I’ve learned that my 60-something parents are healthier than me. My mum walks as fast as a New Yorker, uses weights, and exercises every day. My dad, Mats Haraldsson, rides his bike for hours as a warm-up to his fitness regimen. He’s an amateur lumberjack who still chops his own wood for the fireplace. It’s how he heats our home. I probably will never live up to their fitness lifestyle, but I should take more yoga classes.

This time of enforced togetherness has been a time of discoveries – of differences, but also of finding common ground that we might have forgotten about, or never even known before.

In my bedroom there’s a giant photograph of a tree that my father took when he was young. When I was a child, it had hung in the room where I slept when we visited my grandmother, so I’ve known it my whole life. When I went to art school, my father gave me the camera he used to take the photo.

I never pieced it together before living in quarantine, but my dad helped inspire my love of photography. He thought about being a professional photographer, but he was worried about if he could make a living at it. He’s very security-minded.

“I didn’t think I had the skills to take it to a professional level, but it was something I enjoyed for a few years,” he says.

Now, during the quarantine, I’ve inspired him to pick up his camera again.

As my mum says: “How you look at the quarantine is your choice. You can look at the quarantine as a problem, or you can look at the quarantine as something that gives you two weeks to be with yourself, to think about things, and to develop things which you have no time for otherwise.”

One night during my quarantine, we sat down and interviewed each other about what this time has meant to us, and to the world at large. We’d never done anything like that before, and it was fun and sometimes moving.

My mother said it was hard to keep her distance from me when I arrived home.

“When you came from New York, you know, the natural thing for me is to go forward to you and kiss you and hug you, you know, my little girl,” she said. But even though we couldn’t touch, “it’s nice to, you know, have this feeling of having you close to me.”

My dad said he was glad I was home. “We have to gather in these days,” he said.

We talked about what we were most worried about. For me, it’s my mum. She’s in a higher-risk category, and she’s been coughing. I’m afraid that without showing any symptoms, I’ve brought the disease with me from New York.

My mum fears getting ill, but she also worries about her country and the world as a whole.

“I’m a bit worried about how this is going to develop. Yes, not only because I’m in the risk group, but for the whole society. What’s going to happen?” she said. “What kind of a Norway will this be when the virus is over or if it will be over?

“I am scared that it should get up the worst in people. And I hope it will take up the best in people.”

We looked for the blessings in this time we never wanted or expected.

“There have been many plagues in the history of humanity, and we have always continued in one way or another,” my dad said. “Maybe it will put us back to enjoy today because we don’t know so much about tomorrow.”

My mum, who knows something about not taking life for granted, said: “You have to live every day. And maybe don’t think so much about the future. The future will come, but what the future will be, we don’t know. But it will come. So it is to live every day as good as possible and enjoy every day.”

This disease has shown us how interconnected we all are, in scary ways, but possibly also good ones. We’ve seen how one place in the world might affect the rest of us.

“So it’s in everybody’s interest that things are going fine all over the place, because it might affect us,” my mum mused. “So maybe we will be more responsible and more conscious about how we act towards other places in the world.”

For me, I think we’re facing a huge change. We’ve been treating this planet terribly for a long time, and I think we might come out of this as better people but also with a better planet.

But on a more personal level, even though I’ve sometimes felt restless and confined in my old home, this quarantine has given me a precious time with my parents.

I’m the journalist, but they interviewed me that night too. This is what I said.

“The best part is that I’m getting a lot closer to you guys, and I don’t think I would ever get this close if it hadn’t been for me literally being locked down in this house. … And I think a lot of people will come out of this knowing the people they lived in the house with better. And I’m very grateful for that.”

(Reporting by Nora Savosnick; editing by Kari Howard)